围孕期空气污染物暴露与妊娠期贫血的关联研究  

Association between peri-conceptional air pollution exposure and anemia in pregnancy

作　　者：李蕾 刘洋 李培[1,2,3] 周美婷 缪梦娇[1] 陈添翼 朱鹏 LI Lei;LIU Yang;LI Pei;ZHOU Mei-ting;MIAO Meng-jiao;CHEN Tian-yi;ZHU Peng(Department of Maternal,Child and Adolescent Health,School of Public Health,Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,安徽合肥230032 [2]人口健康与优生安徽省重点实验室,安徽合肥230032 [3]出生人口健康教育部重点实验室,安徽合肥230032 [4]国家卫生健康委配子及生殖道异常研究重点实验室,安徽合肥230032

出　　处：《现代预防医学》2021年第12期2149-2154,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(81872631,81472991);安徽省高校优秀青年人才基金重点项目(gxyqZD2018025);安徽省学术和技术带头人后备人选科研资助项目(2017H141)。

摘　　要：目的探讨孕前期和孕早期主要空气污染物暴露与孕中期贫血发生风险间的关系。方法在合肥市3家医院招募3427名孕中期产检的孕妇作为研究对象。通过问卷调查收集人口学特征、健康状况和生活方式等信息,常规检查获得血红蛋白(hemoglobin,Hb)浓度并诊断贫血。结果孕中期贫血发生率为35.5%。多因素logistic回归分析结果显示,在单污染物模型中,孕前期NO2(OR=1.45,95%CI:1.33~1.57)及孕早期O3和NO2暴露均与孕期贫血风险增加显著相关,但在双污染物模型中,仅孕前期NO2与贫血风险仍存在统计学关联。多因素线性回归分析结果显示,在单污染物模型中,孕前期NO2(β=-2.02,95%CI:-2.34~-1.70)及孕早期O3(β=-2.61,95%CI:-3.23~-2.00)和NO2(β=-1.59,95%CI:-2.04~-1.15)暴露与Hb浓度呈显著负相关,在双污染物模型中,上述统计学关联仍存在。多项式曲线拟合结果显示,孕前期和孕早期NO2暴露浓度与Hb浓度之间均存在负性线性关系(P<0.05)。结论围孕期NO2暴露与Hb浓度降低有关,并增加妊娠期贫血风险。Objective To explore the association between the exposure to major air pollutants during pre-pregnancy and early pregnancy and anemia in the second trimester. Methods From March 2015 to January 2019, a total of 3 427 pregnant women in the second trimester were recruited from three hospitals in Hefei. Demographic characteristics, health status and lifestyle information were collected through questionnaires, hemoglobin concentration was obtained through routine examinations, and anemia was diagnosed. Results The incidence of anemia in the second trimester was 35.5%. Multivariate logistic regression model results showed that in single-pollutant models, exposure to NO2(OR=1.45, 95% CI:1.33-1.57) during pre-pregnancy,and O3 and NO2 during early pregnancy were significantly associated with increased risk of anemia during pregnancy, but in two-pollutant models, only NO2 exposure during pre-pregnancy was statistically associated with risk of anemia. Multivariate linear regression model results showed that in single-pollutant models, exposure to NO2 during pre-pregnancy and early pregnancy(β=-2.02, 95% CI:-2.34--1.70;β=-1.59, 95% CI:-2.04--1.15, respectively) and O3 during early pregnancy(β=-2.61,95% CI:-3.23--2.00) were significantly negatively correlated with hemoglobin concentration, and in two-pollutant models, the statistical association still existed. The polynomial curve fitting results showed that there was a negative linear relationship between NO2 and hemoglobin concentration in pre-pregnancy and early pregnancy(P<0.05). Conclusion Peri-conceptional NO2 exposure was associated with decreased hemoglobin concentration and increased risk of anemia during pregnancy.

关 键 词：围孕期 贫血 妊娠 空气污染物 

分 类 号：R714.254[医药卫生—妇产科学] X51[医药卫生—临床医学]